SORROW, PITY, OUTRIGHT FEAR: Should we the people be concerned...

MONDAY, APRIL 20, 2026

...about the president's (mental) health? We'll start the week with a basic question. As we do, we'll be starting to wind down the past several weeks of reports.

As we start the week, our basic question is this:

Should American citizens be concerned about the state of the president's mental health? More directly, should American citizens be fearful—frightened, afraid—about his mental health?

We refer to any possible cognitive decline, but also to any possible "mental illness." And because the language of "mental illness" is often taken to be, and is frequently offered as, the ultimate form of insult, we want to start the week by restating some basic conceptual points:

A mental illness is, in fact, an illness:

In our view, a (serious) "mental illness" is, in fact, an illness. 

When someone is diagnosed with a significant "mental illness," that's a diagnosis of an actual illness. It isn't simply a shorthand way of saying that the person's behavior is very bad.  

Some such diagnosis is a diagnosis of a personal tragedy, as would be the case with a serious "physical" illness. The assertion of a possible "mental illness" shouldn't be seen as an insult.

Also this:   

A mental illness frequently is a physical illness:

"Mental illnesses" frequently have a physiological component. The leading authority on mental illness prefers the emerging term "mental disorder." But this is one part of its overview:  

Mental disorder   

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context.

[...]  

For a mental state to be classified as a disorder, it generally needs to cause dysfunction. Most international clinical documents use the term mental "disorder", while "illness" is also common. It has been noted that using the term "mental" (i.e., of the mind) is not necessarily meant to imply separateness from the brain or body. 

A "mental illness" isn't necessarily disconnected from the brain (a physical organ) or the body. For example, in its discussion of antisocial personality disorder (colloquially, "sociopathy"), the leading authority says this:

Antisocial personality disorder

Antisocial personality disorder (ASPD) is a personality disorder defined by a chronic pattern of behavior that disregards the rights and well-being of others. People with ASPD often exhibit behavior that conflicts with social norms, leading to issues with interpersonal relationships, employment, and legal matters. The condition generally manifests in childhood or early adolescence, with a high rate of associated conduct problems and a tendency for symptoms to peak in late adolescence and early adulthood. 

[...]  

Research into genetic associations in antisocial personality disorder suggests that ASPD has some or even a strong genetic basis. The prevalence of ASPD is higher in people related to someone with the disorder. Twin studies, which are designed to discern between genetic and environmental effects, have reported significant genetic influences on antisocial behavior and conduct disorder. 

As its overview continues, the leading authority goes into some detail about the "specific genes" which may be involved in the development of this disorder. Simply put, an unfortunate child may perhaps inherit the physiological condition which correlates with ASPD. 

We've advised you to pity that child—but also to be deeply concerned about where his conduct may lead.

Certain forms of "mental illness" may be surprisingly prevalent:

We'll guess that most people would be surprised by the prevalence of certain "mental disorders" (forms of "mental illness"). In the overview about ASPD to which we've already linked, the leading authority offers this statement concerning the prevalence of ASPD (colloquially, "sociopathy"): 

The estimated lifetime prevalence of ASPD amongst the general population falls within 1% to 4%, skewed towards 6% men and 2% women. 

As we've noted in the past, that six percent figure (among men) is apparently derived from major studies of this "mental disorder." We'll guess that many people would be surprised by that alleged degree of prevalence.

Obviously, that figure doesn't mean that six percent of adult men are the equivalent of Hannibal Lecter. It does mean that some version of this "mental disorder" ("mental illness") is less rare than many people may think.

You're reading this here for a reason:

Please understand:

No one at this site is a medical specialist. No one at this site is experienced in the diagnosis and treatment of various "mental disorders."

You're reading these observations here because our upper-end press corps has sworn that they will never interview the medical specialists who could, at least in theory, offer detailed understanding of these basic points. For better or worse, the state of play is this:

Our journalists have agreed to adhere to a code of silence about matters of "mental illness," at least with respect to major political figures like the sitting president.

When it comes to an important matter like this, we the people have been left on our own.

We've advised you to pity the child who may be afflicted—perhaps through genetic inheritance!—in the deeply unfortunate ways we've described. That said, some medical specialists have said that the sitting president is afflicted in these ways, and that this state of affairs should be viewed as extremely dangerous.

Full disclosure! We know of no reason to believe that this possibility will ever be discussed in the New York Times, or in The Atlantic, or on The Last Word or The Rachel Maddow Show. 

Major news orgs and individual journalists simply aren't going to go there.  Example: When Mary L. Trump stated her view on CNN in late February, the interview ended right there, and it was never mentioned again!

That said, an obvious question seems to prevail:

Should we the people be concerned about the president's "mental health?" More to the point, should we the people be actively fearful about that matter?

Way back in the president's first term, some major medical specialists said the answer was clearly yes.  The fact that they said it doesn't make it true, but that's what those specialists said.

This week, we'll finish our review of these matters. As a general matter, we've advised you to pity the child, but also to consider the possibility of fearing his behavior.

Remember:

You're reading about this topic at this site for a somewhat unusual reason. For better or worse, our high-end journalists have agreed on a basic point:

This topic must never be discussed! It simply isn't done!

We the people have been left on our own. We'll review some basic points during the rest of the week.

Tomorrow: Correctly or otherwise, this was an early warning